Older Adults and the Economic Impact of the COVID-19 Pandemic

Age-related differences in the association between financial hardship and weight change during the COVID-19 pandemic

Objective

To examine the association of financial hardship with weight changes in the US during the COVID-19 pandemic.

Methods

We used data from the COVID-19's Unequal Racial Burden survey, a nationally representative, cross-sectional, online survey of diverse adults living in the US, 12/2020-2/2021. This study included 1000 Asian, Black, Latino (half Spanish-speaking), and White adults and 500 American Indian or Alaska Native, Native Hawaiian or Pacific Islander, and multiracial adults (5500 total). Age-specific (18-39, 40-59, ≥60) associations between financial hardship domains and weight change were estimated using multinomial logistic regression, adjusted for demographic and health characteristics.

Results

Financial hardship during the COVID-19 pandemic was prevalent across all age groups (18-39: 76.2 %; 40-59: 75.6 %; ≥60: 50.6 %). Among adults aged 18-39 and ≥ 60 years old, food insecurity was significantly associated with weight loss (18-39: aOR = 1.42, 95 % CI = 1.04, 1.95; ≥60: aOR = 3.67, 95 % CI = 1.50, 8.98). Among all age groups, unmet healthcare expenses was also associated with weight loss (18-39: aOR = 1.31, 95 % CI = 1.01, 1.70; 40-59: aOR = 1.49, 95 % CI = 1.06, 2.08; ≥60: aOR = 1.73, 95 % CI = 1.03, 2.91). Among adults aged 18-39 and ≥ 60 years old, lost income was significantly associated with weight gain (18-39: aOR = 1.36, 95 % CI = 1.09-1.69; ≥60: aOR = 1.46, 95 % CI = 1.04, 2.06), and among adults 40-59 years old, experiencing increased debt was significantly associated with weight gain (aOR = 1.50, 95 % CI = 1.13, 1.99).

Conclusions

For those aged 18-39 and ≥ 60 years old experiencing financial hardship during the COVID-19 pandemic was associated with both weight loss and weight gain. Less correlation was observed among adults aged 40-59.

Social and Structural Determinants of Health Associated with COVID-19 Vaccine Hesitancy among Older Adults in the United States

State-level COVID-19 vaccination rates among older adults have been uneven in the United States. Due to the immunocompromised nature of older adults, vaccine hesitancy increases the risk of morbidity and mortality. This study aims to determine the association between the social determinants of health, the structural determinants of health, and COVID-19 vaccine hesitancy among older adults in the United States. Secondary data from the Health and Retirement Study (HRS) dataset were used. A descriptive analysis and multinomial multivariable logistic regression were performed to examine the association of the independent variables-gender, age, race, immigration status, marital status, broadband internet access, social security income, Medicare coverage, education, and frequency of religious service-with the dependent variable, vaccine hesitancy. Compared to the respondents with no vaccine hesitancy and without the specific predictor, the respondents who reported religious attendance at least once/week were more likely to be "somewhat hesitant", divorced respondents had higher odds of being "somewhat hesitant", and older adults aged 65-74 years were more likely to be "very hesitant" or "somewhat hesitant" about the COVID-19 vaccine. Compared to the respondents with no vaccine hesitancy and without the specific predictor, females had higher odds of being "very hesitant", "somewhat hesitant", or a "little hesitant", and African Americans were more likely to be "very hesitant", "somewhat hesitant", or a "little hesitant" about the COVID-19 vaccine. Addressing these factors may limit the barriers to vaccine uptake reported among older adults and improve herd immunity among the immunocompromised population.

A new subjective well-being index using anchored best-worst scaling

Subjective well-being (SWB) describes an individual's life evaluation. Direct elicitation methods for SWB via rating scales do not force individuals to trade-off among life domains, whilst best-worst scaling (BWS) approaches only provide relative measures. This paper instead offers a dual-response BWS task, where respondents nominate areas of most and least importance and satisfaction with respect to 11 SWB domains, whilst also eliciting anchoring points to obtain an absolute measure of domain satisfaction. Combining domain satisfaction and importance produces a robust measure of individual SWB, but statistically unique relative to other life satisfaction measures utilizing single- and multi-item ratings, including global satisfaction and those aggregated over SWB domains, as well as eudemonia. Surveying 2500 Australians reveals anchored-BWS improves discrimination amongst domains in terms of importance and satisfaction, illustrating its value as a diagnostic tool for SWB measurement to focus services, policy, and initiatives in areas to most impact wellbeing. This includes highlighting a major discrepancy between health satisfaction and importance, whilst also reporting that SWB is significantly lower for Indigenous, unemployed, middle-aged, males and lower income groups.

Attitudes and perceptions toward the COVID-19 risk-mitigation strategies among racially and ethnically diverse older adults in the United States and Puerto Rico: a qualitative study

OBJECTIVES

There is limited qualitative research investigating how risk-mitigation strategies during the COVID-19 pandemic impacted the lives of diverse older adults, who met criteria for mild to severe generalized anxiety or depression and minor to moderate disability. This study aims to address this gap by examining how racially and ethnically diverse older adults with at least mild mental health symptoms and minor physical disability in the United States and Puerto Rico adapted to guidelines during COVID-19. It aims to inform the medical community and policymakers of potential threats to these older adults' well-being given the COVID-19 burden.

DESIGN

Based on descriptive qualitative inquiry and phenomenological perspectives, we conducted semi-structured interviews over the phone with a racially and ethnically diverse sample of older (age 60+), predominantly minoritized adults (N = 100) in four states and territories across the United States and Puerto Rico in 2021. Interviews were recorded, coded, and analyzed using a thematic analysis approach.

RESULTS

Findings centered on five themes: (1) Previous experiences with the healthcare system and cultural beliefs related to trust and distrust led to mixed attitudes toward COVID-19 risk-mitigation strategies; (2) Compliance with COVID-19 mitigation strategies ensured safety and addressed fear of illness; (3) Compliance led to isolation due to interrupted social relations; (4) Isolation and disrupted social networks negatively impacted mental health and finances, and (5) Coping strategies and embracing support reduced the effects of social isolation.

CONCLUSION

This study underscores the importance of increasing support and social connectedness during a pandemic and beyond to ensure the well-being of older adults in racially and ethnically diverse communities. It highlights the resiliency of older adults in identifying strategies to cope with negative impacts. We recommend safeguarding economic security through policy efforts toward financial safety nets during health crises and collaborative approaches with community-based organizations to mitigate social isolation.

Cognitive frailty and its association with depression, anxiety and stress during the COVID-19 pandemic among older adults in the transforming cognitive frailty into later-life self-sufficiency (AGELESS) study

BACKGROUND

Cognitive frailty describes the co-occurrence of cognitive impairment and physical frailty and is classified into reversible and irreversible phenotypes. Data on the impact of COVID-19 pandemic imposed lockdowns, locally known as the Movement Control Order (MCO), on the psychological status of cognitively frail older adults remain scarce. Therefore, this study aimed to determine the relationship between depression, anxiety, stress and cognitive frailty among older adults during the MCO.

METHOD

Participants aged above 60 years from three ageing cohorts in Malaysia were interviewed virtually. The Fatigue, Resistance, Ambulation, Illness and Loss of Weight scale, blind Montreal Cognitive Assessment, 15-item Geriatric Depression Scale, anxiety subscale of Depression, Anxiety and Stress Scale and four-item Perceived Stress Scale measured frailty, mild cognitive impairment (MCI), depression, anxiety and stress, respectively.

RESULTS

Cognitive frailty data were available for 870 participants, age (mean ± SD) = 73.44 ± 6.32 years and 55.6% were women. Fifty-seven (6.6%) were robust, 24 (2.8%) had MCI, 451 (51.8%) were pre-frail, 164 (18.9%) were pre-frail+MCI, 119 (13.7%) were frail and 55 (6.3%) were frail+MCI. There were significant differences in depression and anxiety scores between the controlled MCO and recovery MCO. Using multinomial logistic regression, pre-frail (mean difference (95% confidence interval, CI) = 1.16 (0.932, 1.337), frail (1.49 (1.235, 1.803) and frail+MCI (1.49 (1.225, 1.822)) groups had significantly higher depression scores, frail (1.19 (1.030, 1.373)) and frail+MCI (1.24 (1.065, 1.439)) had significantly higher anxiety scores and pre-frail (1.50 (1.285, 1.761)), frail (1.74 (1.469, 2.062)) and frail+MCI (1.81 (1.508, 2.165)) had significantly higher stress scores upon adjustments for the potential confounders. The MCO was a potential confounder in the relationship between depression and prefrail+MCI (1.08 (0.898, 1.340)).

CONCLUSION

Frail individuals with or without MCI had significantly higher depression, anxiety and stress than those who were robust. Increased depression and stress were also observed in the pre-frail group. Interventions to address psychological issues in older adults during the COVID-19 pandemic could target prefrail and frail individuals and need further evaluation.

Changes in late-life assistance networks for Black and White older adults during the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic has disproportionately impacted older Black Americans. Given that assistance networks play a crucial role in older adults' ability to respond to challenges, we sought to investigate whether older adults' assistance network size changed during the COVID-19 pandemic and differed by race.

METHODS

We analyzed data from the 2018-2020 rounds of the U.S. National Health and Aging Trends Study for Black and White adults aged 70 and older receiving help in the community or residential care settings. We used ordinary least squares regression to compare changes in assistance network size in the 2 years pre-COVID-19 (2018-2019, N = 3438) to changes in size at the onset of COVID-19 (2019-2020, N = 3185).

RESULTS

Black older adults had larger assistance networks with a greater number of family helpers before and during the pandemic compared to their White counterparts. Assistance network size for older adults increased before but not during the pandemic mostly due to declines in unpaid nonrelative helpers and lack of increase in paid helpers. These effects did not differ by race.

CONCLUSIONS

Black and White older adults experienced similarly sized reductions in their assistance networks as a consequence of the COVID-19 pandemic. Future research should investigate the relationship between these network changes and the unmet needs of older adults.

Depression during the COVID-19 pandemic among older Canadians with peptic ulcer disease: Analysis of the Canadian Longitudinal Study on Aging

The COVID-19 pandemic and associated public health measures have exacerbated many known risk factors for depression that may be particularly concerning for individuals with chronic health conditions, such as peptic ulcer disease (PUD). In a large longitudinal sample of older adults with PUD, the current study examined the incidence of depression during the pandemic among those without a pre-pandemic history of depression (n = 689) and the recurrence of depression among those with a history of depression (n = 451). Data came from four waves of the Canadian Longitudinal Study on Aging (CLSA). Multivariate logistic regression analyses were conducted to identify factors associated with incident and recurrent depression. Among older adults with PUD and without a history of depression, approximately 1 in 8 (13.0%) developed depression for the first time during the COVID-19 pandemic. Among those with a history of depression, approximately 1 in 2 (46.6%) experienced depression during the pandemic. The risk of incident depression and recurrent depression was higher among those who were lonely, those with functional limitations, and those who experienced an increase in family conflict during the pandemic. The risk of incident depression only was higher among women, individuals whose income did not satisfy their basic needs, those who were themselves ill and/or those whose loved ones were ill or died during the pandemic, and those who had disruptions to healthcare access during the pandemic. The risk of recurrent depression only was higher among those with chronic pain and those who had difficulty accessing medication during the pandemic. Implications for interventions are discussed.

Medication adherence in Medicare-enrolled older adults with asthma and chronic obstructive pulmonary disease before and during COVID-19 pandemic

Background

Medication adherence in Medicare-enrolled older adults with asthma and chronic obstructive pulmonary disease (COPD) before and during the coronavirus disease 2019 (COVID-19) pandemic is unknown.

Objectives

To evaluate medication adherence and determinants of high adherence before and during the COVID-19 pandemic in this population.

Design

Retrospective cohort study.

Methods

The proportion of days covered (PDC) reflected medication adherence from January to July 2019 and from January to July 2020. Patients <65 years of age, with COPD or asthma alone, or with cystic fibrosis were excluded. Paired t tests were used to assess adherence changes. Logistic regression explored association of age, sex, diagnosis of depression, number of medications, medication-related problems, prescribers, pharmacies, controller medication classes, albuterol rescue inhaler fills, oral corticosteroid fills, and having a 90-day supply with high adherence (PDC ⩾ 80%).

Results

This analysis included 989 patients. In this cohort, 61.2% of patients received oral corticosteroids. Over 60% of patients had ⩾3 rescue fills in both 2019 and 2020. Medication adherence to controller medications significantly decreased for all controller medications (p < 0.001) in 2020. In 2019 and 2020, number of controller medication classes and having a 90-day supply were associated with high adherence (p < 0.001). In 2019, variables associated with high adherence also included number of medication-related problems and having ⩾3 albuterol rescue inhalers (p < 0.001).

Conclusion

Medication adherence to controllers significantly decreased during the pandemic among older adults with asthma and COPD. Patients with multiple controller classes and a 90-day supply were more likely to be highly adherent. A 90-day supply of medications should be used to facilitate access to medication during the pandemic. Healthcare professionals should assess medication adherence, resolve the barriers of adherence and medication-related problems to achieve desired clinical outcomes among older adults with both asthma and COPD.

The effects of COVID-19-era unemployment and business closures upon the physical and mental health of older Europeans: Mediation through financial circumstances and social activity

COVID-19-era lockdown policies resulted in many older persons entering unemployment, facing financial difficulties and social restrictions, and experiencing declining health. Employing the Survey of Health, Ageing and Retirement in Europe's first COVID-19 module (summer 2020) (N = 11,231) and the Karlson-Holm-Breen method for decomposition of effects within non-linear probability models (logistic regression modelling), we examined associations of pandemic-era lost work with older Europeans' (50-80 years of age) self-assessed health, depressive symptoms, and anxiety symptoms, and mediation through households' difficulties making ends meet, loneliness, and curtailed face-to-face contact with non-relatives. We find that lost work was associated with detriments in all three health outcomes. Total mediation was 23% for worsened self-assessed health, 42% for depressive symptoms, and 23% for anxiety symptoms. In all cases, combined mediation through the two social activity variables was approximately twice the magnitude of mediation through household financial difficulties. This evidence highlights the extent of employment's value for friendship formation and sustenance, and social activity, during the pandemic-era social restrictions. This might be accentuated among older persons because of the social constrictions often concomitant to advancing age. These results emphasize that the social correlates of lost employment, beyond the financial concomitants, should receive thorough research and policy attention, perhaps especially for older adults during public health crises.

Relations Between Guardians and Domestic Animals During the Sars-Cov-2 Pandemic in Brazil

OBJECTIVE

The aim of this study was to evaluate how relationships between guardians and domestic animals were established and their possible effects during the COVID-19 pandemic period in Brazil.

METHODS

Data were collected by completing an online questionnaire. Throughout the national territory, 2002 people completed the questionnaire, while respecting social distancing from January 20, 2021, to March 20, 2021. The inclusion and exclusion criteria were 'to own pets' or 'those who had them during the period of quarantine' in Brazil. The data obtained were treated qualitatively through discourse analysis and content analysis, while the quantitative data were tabulated by the questionnaire application platform itself.

RESULTS

The results showed that 97% of the participants were affected by the coronavirus pandemic in Brazil and that of these, 95.5% stated that their pet was important to overcome and bear bad feelings during the period of social isolation. It was possible to observe through the participants' reports through the online questionnaire that the relationships with their pets were deepened during the pandemic period, and that these had an important role in overcoming bad emotions caused by social distancing.

CONCLUSION

It was concluded that due to these relationships, behaviors such as anxiety and sadness were reduced and the pets themselves also showed an increase in affective behaviors in relation to their guardians.

Socio-economic outcomes of COVID-19 on the marginalised: Who have taken the hardest hit?

This article aims to examine the socioeconomic outcomes of COVID-19 for socially marginalised people who are clients of social care organisations (e.g. people experiencing homelessness), and the factors influencing these outcomes. We tested the role of individual and socio-structural variables in determining socioeconomic outcomes based on a cross-sectional survey with 273 participants from eight European countries and 32 interviews and five workshops with managers and staff of social care organisations in ten European countries. 39% of the respondents agreed that the pandemic has had a negative effect on their income and access to shelter and food. The most common negative socio-economic outcome of the pandemic was loss of work (65% of respondents). According to multivariate regression analysis, variables such as being of a young age, being an immigrant/asylum seeker or residing in the country without documentation, living in your own home, and having (in)formal paid work as the main source of income are related to negative socio-economic outcomes following the COVID-19 pandemic. Factors such as individual psychological resilience and receiving social benefits as the main source of income tend to "protect" respondents from negative impacts. Qualitative results indicate that care organisations have been an important source of economic and psycho-social support, particularly significant in times of a huge surge in demand for services during the long-term crises of pandemic.

Did Resilience and Socioeconomic Status Predict Older Adults' Finding a Silver Lining in COVID?

Background and Objectives

The coronavirus disease 2019 (COVID-19) pandemic stretched our limits-physically, mentally, and economically. However, some older adults report that it led to positive changes. This study aims to understand whether prepandemic resilience, education, or income predicted older adults' subsequent likelihood of reporting positive changes in their lives during the pandemic.

Research Design and Methods

We use data from the National Social Life, Heath, and Aging Project, an ongoing panel study with a COVID-19 ancillary supplement (N = 2,650).

Results

The study results aligned with the fundamental cause theory. In demographically adjusted models including resilience, education, and income, as well as the effect of the pandemic on employment and a COVID-disruption score, the odds of reporting any positive change were 2.6 times higher for those with an associate degree (p < .01) and 4.7 times higher for those with a bachelor's or higher (p < .001), compared to those without a high school degree. In contrast, neither resilience nor income was significantly associated with endorsing a positive change. We also categorize specific changes thematically coded from open-ended responses and examine their demographic distributions. Categories include spirituality, home organization, hygiene practices, and increased quality time with others.

Discussion and Implications

These findings show that older adults with more education could navigate COVID-19 challenges in a way that improved their perspectives on at least one aspect of their lives.

The effect of psychological factors on financial behaviour among older Australians: Evidence from the early stages of COVID-19 pandemic

The current study investigated the association between psychological factors and financial behaviour during the COVID-19 pandemic in older people. Older people were chosen compared to other age groups because of the relatively greater impact in this age group of suboptimal financial decisions on future financial wellbeing. We hypothesised that the psychological factors facilitating general wellbeing during the COVID-I9 pandemic, i.e., positive mental wellbeing, hope, and positive coping, will have positive effects on financial behaviour. Based on telephone interviews, 1501 older Australians (Men = 750 and Women = 751; 55-64y = 630; > 65y = 871) completed an omnibus questionnaire examining coping, hope, mental wellbeing, and financial behaviour. Data was analysed using logistic regression and an ordinary and two-stage least square frameworks. Analyses revealed that the psychological factors identified as facilitating general wellbeing during the COVID-I9 pandemic also facilitated positive financial behaviour with hope and mental wellbeing emerging as significant determinants. Based on weightings from principal component analysis, one item each from the hope and mental wellbeing scale with eigenvalues > 1 were found to be robust predictors of positive financial behaviours. In conclusion, the findings support the assumption that the psychological factors associated with general wellbeing during the COVID-19 pandemic are also associated with positive financial behaviour. They further raise the possibility that single hope and positive mental well-being items can also be used to monitor psychological health and predict financial behaviour in older people and, in particular, at times of crisis. The latter may be useful measures for government to monitor psychological and financial wellbeing and inform policy for supporting older people at times of crisis.

Face mask is an efficient tool to fight the Covid-19 pandemic and some factors increase the probability of its adoption

This study examines the dynamic impact of face mask use on both infected cases and fatalities at a global scale by using a rich set of panel data econometrics. An increase of 100% of the proportion of people declaring wearing a mask (multiply by two) over the studied period lead to a reduction of around 12 and 13.5% of the number of Covid-19 infected cases (per capita) after 7 and 14 days respectively. The delay of action varies from around 7 days to 28 days concerning infected cases but is more longer concerning fatalities. Our results hold when using the rigorous controlling approach. We also document the increasing adoption of mask use over time and the drivers of mask adoption. In addition, population density and pollution levels are significant determinants of heterogeneity regarding mask adoption across countries, while altruism, trust in government and demographics are not. However, individualism index is negatively correlated with mask adoption. Finally, strict government policies against Covid-19 have a strong significant effect on mask use.

The Relationship of Food Insecurity to Nutritional Risk in Independent Living Older Adults

Understanding the factors that augment optimal health during aging is critical as the US older adult population is increasing. Most research about food insecurity, nutritional risk, and perceived health among older adults are in urban areas or congregate living facilities. Thus, the purpose of this project was to study the relationships among these factors, plus activities of daily living, in community-dwelling older adults in a medium-sized city. Using a qualitative-quantitative study design, a cross-sectional survey was completed by 167 low-income senior apartment residents. Food insecurity in this group was higher than the national and state rate, yet nutrition assistance programs were underutilized and participants under 75 years were more food insecure than their older counterparts. Food insecure residents were at greater nutritional risk, had poorer self-reported health status, were more likely to be depressed, and had a less independent function, including limitations on the ability to shop for and prepare food. The study area is desirable to retirees due to lower cost of living; however, access to services, such as grocery stores, public transportation, and health care providers is limited. This research indicates the need for increased outreach, nutrition assistance, and support services to ensure healthy aging in these regions.

Understanding the travel challenges and gaps for older adults during the COVID-19 outbreak: Insights from the New York City area

The COVID-19 pandemic has greatly impacted lifestyles and travel patterns, revealing existing societal and transportation gaps and introducing new challenges. In the context of an aging population, this study investigated how the travel behaviors of older adults (aged 60+) in New York City were affected by COVID-19, using an online survey and analyzing younger adult (aged 18-59) data for comparative analysis. The purpose of the study is to understand the pandemic's effects on older adults' travel purpose and frequency, challenges faced during essential trips, and to identify potential policies to enhance their mobility during future crises. Descriptive analysis and Wilcoxon signed-rank tests were used to summarize the changes in employment status, trip purposes, transportation mode usage, and attitude regarding transportation systems before and during the outbreak and after the travel restrictions were lifted. A Natural Language Processing model, Gibbs Sampling Dirichlet Multinomial Mixture, was adopted to open-ended questions due to its advantage in extracting information from short text. The findings show differences between older and younger adults in telework and increased essential-purpose trips (e.g., medical visits) for older adults. The pandemic increased older adults' concern about health, safety, comfort, prices when choosing travel mode, leading to reduced transit use and walking, increased driving, and limited bike use. To reduce travel burdens and maintain older adults' employment, targeted programs improving digital skills (telework, telehealth, telemedicine) are recommended. Additionally, safe, affordable, and accessible transportation alternatives are necessary to ensure mobility and essential trips for older adults, along with facilitation of walkable communities.

Happiness in Old Age: The Daughter Connection

Family and intergenerational relationships are becoming increasingly important as sources of support and care for the elderly population in rapidly ageing Asian societies. However, this has also raised concerns over reinforcement of cultural preference for sons as a source of old-age security. This paper therefore revisits the question-what determines happiness in old age-by investigating the role of adult children's gender in the context of Thailand, an ageing Asian country with no legacy of sex-preference in fertility. We employ nationally representative data to examine the association between old-age happiness and presence of a co-residing child. Compared to living alone, living with at least one child is found to positively associate with older persons' happiness. However, this result is specific to daughters. Moreover, compared to older men, women systematically benefit from a "daughter effect". Co-residing daughters with university education and those who maintain a good relationship with their parents help explain the positive happiness effect on older persons. Co-residing daughters are also positively linked to  reduced loneliness; improved self-rated health; and improved economic conditions of older parents. Our findings suggest that policies that increase human capital of the girl child and enhance family solidarity are likely to have long term intergenerational wellbeing benefits.

Acceptability of a Health Care App With 3 User Interfaces for Older Adults and Their Caregivers: Design and Evaluation Study

BACKGROUND

The older population needs solutions for independent living and reducing the burden on caregivers while maintaining the quality and dignity of life.

OBJECTIVE

The aim of this study was to design, develop, and evaluate an older adult health care app that supports trained caregivers (ie, formal caregivers) and relatives (ie, informal caregivers). We aimed to identify the factors that affect user acceptance of interfaces depending on the user's role.

METHODS

We designed and developed an app with 3 user interfaces that enable remote sensing of an older adult's daily activities and behaviors. We conducted user evaluations (N=25) with older adults and their formal and informal caregivers to obtain an overall impression of the health care monitoring app in terms of user experience and usability. In our design study, the participants had firsthand experience with our app, followed by a questionnaire and individual interview to express their opinions on the app. Through the interview, we also identified their views on each user interface and interaction modality to identify the relationship between the user's role and their acceptance of a particular interface. The questionnaire answers were statistically analyzed, and we coded the interview answers based on keywords related to a participant's experience, for example, ease of use and usefulness.

RESULTS

We obtained overall positive results in the user evaluation of our app regarding key aspects such as efficiency, perspicuity, dependability, stimulation, and novelty, with an average between 1.74 (SD 1.02) and 2.18 (SD 0.93) on a scale of -3.0 to 3.0. The overall impression of our app was favorable, and we identified that "simple" and "intuitive" were the main factors affecting older adults' and caregivers' preference for the user interface and interaction modality. We also identified a positive user acceptance of the use of augmented reality by 91% (10/11) of the older adults to share information with their formal and informal caregivers.

CONCLUSIONS

To address the need for a study to evaluate the user experience and user acceptance by older adults as well as both formal and informal caregivers regarding the user interfaces with multimodal interaction in the context of health monitoring, we designed, developed, and conducted user evaluations with the target user groups. Our results through this design study show important implications for designing future health monitoring apps with multiple interaction modalities and intuitive user interfaces in the older adult health care domain.

COVID-19 and its impact on mental health as a function of gender, age, and income

This paper examines the impact of COVID-19 on the mental health of people from different socioeconomic classes. This has been done by creating an anxiety score, based on responses to a set of questions that were asked as part of a two-round telephonic survey done by Young Lives Data for India. Using this index, anxiety levels have been classified as high, medium, and low. As the dependent variable has an ordered nature, an ordered logit model has been used for regression. According to the results, job loss, death of the family's earning member or mishap in the family, and price increases all contributed to increased anxiety. The analysis indicates that anxiety levels among women were higher than among men because of the increased burden of household chores and childcare responsibilities. Also, anxiety levels were higher among those who perceived themselves as rich or poor as opposed to those who were comfortable in their income group. There was a higher anxiety level among the rich due to income loss and increased household responsibilities. A high percentage of children and elders reported feeling anxious; school closures and a lack of social interaction caused stress. Isolation also plagued the elderly. Furthermore, many students couldn't avail online learning opportunities due to a lack of resources. The government implemented many policies to mitigate these issues, which included those to mitigate the immediate hunger problem.

The economic impact of the first wave of the pandemic on 50+ Europeans

We analyse the effects of the first wave of the COVID-19 crisis on the economic situation of 50+ Europeans. We construct a financial distress indicator that captures experiencing an income loss, difficulties to make ends meet and the need to postpone payments. We find that education and income before the pandemic has a protective role, and so does being past retirement age. For households under retirement age, instead, the pandemic has exacerbated inequalities. We also investigate whether households report worse difficulties in making ends meet compared to the pre-COVID-19 period. We show that their ability to make ends meet worsens more with income losses during the pandemic compared to losses experienced in the two-year period before the pandemic.

“Even though we are elders living alone”: has social support reshaped the care of older adults during the COVID-19 pandemic?

Purpose

This study aims to explore how social support has reshaped the care of older adults living alone in northeast Thailand during the COVID-19 pandemic.

Design/methodology/approach

This study used a qualitative method using a narrative gerontological perspective with a descriptive design. Purposive sampling was conducted from 20 in-depth narrative interviews between November 2021 and February 2022 in Maha Sarakham province, northeast Thailand. Data transcriptions were performed using a narrative analytical process.

Findings

The in-depth narrative interviews indicated that older adults living alone during the coronavirus pandemic valued a comfortable life, a sense of place, favourable living arrangements, self-reliance, life goals and meaningful life. The gerontological analysis showed that social support for older adults living alone included a social safety net, networking, supporting needs, physical care and mental health responses to the COVID-19 pandemic.

Originality/value

To the best of the authors’ knowledge, this is the first qualitative narrative gerontological study to explore how social support reshaped the care of older adults living alone during the COVID-19 pandemic in northeast Thailand.

Racial disparities in unemployment benefits among U.S. mortgage borrowers during COVID-19

This article describes racial and ethnic differences in mortgage payment difficulties during the COVID-19 pandemic and examines whether disparities exist in the benefits of the unemployment insurance (UI) program. The sample consisted of 80,797 jobless mortgage borrowers who received or waited for UI benefits between August 2020 and May 2022. Considering individual- and state-level variables in multilevel logistic regressions, we examined rates of mortgage delay in the last month and payment concerns about the next month by racial and ethnic group. Minority borrowers were more likely to have a difficulty in paying mortgage than White borrowers. UI recipients-regardless of race and ethnicity-were less likely to experience mortgage difficulties, but the positive unemployment benefit was reduced disproportionately among Blacks. Blacks were also at a higher risk of mortgage difficulties compounded by other pandemic-induced hardships-loss of household, lack of food, and mental illness-even after the receipt of UI. Findings on the intersection between race and ethnicity and UI suggest that pandemic policy interventions should be race conscious and consider the longstanding and systematic barriers experienced by minority mortgage borrowers.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10901-022-10006-w.

Investigating mental health outcomes of undergraduates and graduate students in Taiwan during the COVID-19 pandemic

Objective: This study is an exploration of the major stressors associated with the COVID-19 for students in higher education in Taiwan. Participants: The sample comprised 838 higher education students studying at various Taiwanese universities. Methods: A cross-sectional online survey was administered at different postsecondary institutions during the semi-lockdown period of COVID-19, which mandated online instruction. Machine learning was employed to determine the variables that most highly predicted students' mental health using R. Results: The findings revealed that COVID-19-related experiences, including social interactions, financial conditions, and educational experiences, were significantly associated with mental health outcomes. Particularly, loneliness are significantly related to social interactions and educational experiences. Conclusions: Findings revealed that Covid-19 impacted Taiwanese students' financial conditions, educational experiences, and social interactions, which were significant predictors of their mental health outcomes such as anxiety, loneliness and depression. The current study contributes to the gap in knowledge about mental health issues among postsecondary students during the pandemic.

Financial hardship and change in emotional well-being before to during COVID-19 pandemic among middle-aged and older Americans: Moderating effects of internal coping resources

OBJECTIVE

The purpose of this study was to investigate associations between financial hardship and change in emotional well-being-positive and negative affect-before to during the COVID-19 pandemic among middle-aged and older Americans and to examine the extent to which associations were moderated by internal coping resources-dispositional mastery and optimism.

METHOD

Data derived from the Leave-Behind Questionnaire in the 2016 and 2020 waves of the Health and Retirement Study, a nationally representative longitudinal survey of U.S. adults aged 51 and older (N = 1312). We estimated multivariate ordinary least squares regression models with interaction terms to evaluate prospectively the benefits of mastery and optimism as internal coping resources for middle-aged and older adults.

RESULTS

Dispositional mastery moderated the effects of financial hardship on changes in negative and positive affect, respectively, before to during the COVID-19 pandemic; however, optimism did not significantly moderate the effects of financial hardship on change in negative and positive affect before to during the COVID-19 pandemic.

CONCLUSIONS

Our findings have implications for interventions aimed at improving middle-aged and older adults' emotional well-being by promoting internal coping resources. Specifically, interventions should focus on financial hardship and mastery for vulnerable middle-aged and older adults in the context of public health crises.

The intersection of race and financial strain: The pain of social disconnection among women in the United States

Objectives: Considerable attention has been directed at increased social isolation and loneliness during the COVID-19 pandemic and their impact on later-life psychological well-being. There is a dearth of research on the effect of financial strain and associated psychosocial mechanisms on loneliness among women across racial groups. It is unclear how racial status and financial strain intersect to impact later-life loneliness amid immense uncertainty, social isolation, and anxiety induced by the pandemic.Methods: Based on our nationwide Web-based survey (n = 1,301), we used ordinary least square regression to examine the effects of financial strain on loneliness among Black and White women and assessed the role of emotional support in contributing to such effects.Results: We found that Black women face significantly more financial strain than White women but also receive more emotional support and experience less loneliness. Findings show that women experiencing financial strain report increased loneliness, but the negative effects of financial strain are significantly greater for Black women than for White women. Our mediation analysis revealed that emotional support made a significant contribution to the effects of financial strain on loneliness in White women but not in Black women.Discussion: Despite shared vulnerability and social isolation across the general population, our findings suggest that negative effects of financial strain on loneliness among women continue to differ across race, even amid the pandemic. Our findings demonstrate how emotional support explains the relationship between financial strain and later-life loneliness in a racially distinct manner.

The economic impacts of COVID-19 lockdown on low-income older people in Thailand

OBJECTIVES

The aim of this study was to investigate the economic impacts of the COVID-19 lockdown in Thailand on low-income older people concerning their employment, household income and food security. The study also aimed to identify which socioeconomic characteristics of low-income older Thais are at higher risk of being negatively affected and whether they can access state economic relief during the pandemic response in Thailand.

METHODS

Economic, health and social well-being questionnaires were completed by low-income older Thais (n = 808) holding a State Welfare Card during the COVID-19 lockdown in 2020. Descriptive analyses and multivariate logistic regressions were utilized in the data analysis. All analyses were performed using Stata 15.

RESULTS

This study found that 62% of participants experienced a negative impact on their household income, 35% had a negative impact on employment and 20% had a negative impact on food security. However, the impact level depended upon their vulnerability before the pandemic. The study also reveals that older Thais who experienced a negative impact on household income could access monetary relief schemes from the government during the pandemic.

CONCLUSIONS

This study reveals the layers of economic vulnerability among the population of low-income older Thais negatively affected by the 2020 lockdown. Despite the accessible state monetary relief, differential skills with the use of digital technology could create inequitable access to aid measures among older Thais. The findings highlight the need for longitudinal studies to track changes in the economic impacts arising from subsequent waves of COVID-19 on low-income older people.

Teleworkers' job performance: a study examining the role of age as an important diversity component of companies' workforce

Purpose

Teleworking seems to be the new future of the workplace. It has been widely adopted during the COVID-19 crisis, which has greatly influenced work organization conditions. This pandemic and its accompanying changes represent significant challenges for employees' performance, depending on their age if the study considers the physical and psychological vulnerabilities of older employees and their assumed or expected difficulties to cope with the new information and communication technologies (ICTs). This study aims at examining the direct effects of teleworking, and age on job performance (in-role). As well as analyzing the moderating effect of age on the relationship between teleworking and in-role job performance in times of crisis.

Design/methodology/approach

Data were collected in Canada from 18 companies, with a sample of 272 employees. Multivariate regression and moderation regression analyses were performed using Stata 13.

Findings

Results revealed that when teleworking, older age is associated with lower job performance and younger age is associated with higher job performance. Conversely, when working on-site, older age is associated with higher job performance, whereas younger age is associated with lower job performance.

Practical implications

From a practical perspective, these results highlight the importance of decision authority and recognition. As well as the presence of age disparities related to work arrangements. Managers need to adopt an inclusive approach and develop work arrangements that take into consideration employees' needs and ages. Some insights and practical recommendations are presented in this paper to support managers and human resource practitioners.

Originality/value

Studies examining the in-role job performance of teleworkers and the effects of age are sparse. This study helps to expand research on human resources management, job performance and age.

The Psychological Costs of the COVID-19 Pandemic and Heterogeneous Effects in South Korea: Evidence from a Difference-in-Differences Analysis

This study estimates the effects of the COVID-19 pandemic on life satisfaction and stress and examines whether these effects vary across different sociodemographic groups using a nationally representative sample in South Korea. We estimate the causal effects of COVID-19 on psychological well-being by exploiting regional variation in the spread of the pandemic in South Korea. While the number of confirmed cases was very small in other provinces in the first half of 2020, the coronavirus spread rapidly in Daegu after an outbreak in one church. We employ a difference-in-differences approach that compares changes in people's life satisfaction and stress before-and-after the initial surge of COVID-19 cases in Daegu and other provinces. Our results show that the proportion of people who are dissatisfied with life increased by 2.8-6.5 percentage points more in Daegu than in other provinces after the COVID-19 outbreak. During the same period, the proportion of people who reported feeling stressed increased more in Daegu than in other provinces by 5.8-8.9 percentage points. Our results also suggest that the negative impact of the COVID-19 outbreak on psychological well-being is significantly greater for men, young adults, middle-aged adults, self-employed workers, and middle-income individuals. On the other hand, the proportion of people who report feeling stressed among the highest-educated (a master's degree or higher) and high-income individuals decreased after the onset of the COVID-19 outbreak.

Health Security, Quality of Life and Democracy during the COVID-19 Pandemic: Comparative Approach in the EU-27 Countries

The aim of this paper is to emphasize the role played by the social, economic and political variables in shaping models of sustainable healthcare systems and strategies able to support and improve the quality of life during and after the COVID-19 pandemic. The context of our research is represented by the medical and socioeconomic crises generated by the COVID-19 pandemic. The current pandemic negatively affects healthcare systems, quality of life and the global economy. In this respect, this paper aims to thoroughly scrutinize the effects of the COVID-19 pandemic on the social and healthcare systems of EU countries, to analyze the impact of human development in the field of the Global Health Security Index and to estimate the relation between resilience and quality of life during the COVID-19 pandemic. The research design is quantitative, resorting to the use of both descriptive and inferential statistics, against the background of a long-term comparative approach to the respective situations in the EU-27 countries. Empirical findings are relevant for emphasizing the fact that human development and social progress are predictors for the dynamics of health security measures. Moreover, the quality of the political regime, particularly in the case of full and flawed democracies, is strongly related to a high level of resilience and could influence the perception of quality of life. All of these empirical results could prove valuable for scholars interested in understanding the relationships between democracy, healthcare systems and quality of life, and for political decision makers involved in the effort of reducing the negative effects of COVID-19 in EU-27 countries.

Iranian older adults women: The Impact of COVID-19 and Coping Strategies

In the field of epidemics, some vulnerable groups, such as older adults, are at greater risk. Many psychological, social, economic and physical hazards have threatened older adults during the COVID-19 pandemic. Some threats can be managed with medical system interventions. However, social and psychological challenges cannot be controlled quickly. People will have a better quality of life if they can take appropriate action in critical situations. There is a strong theoretical and empirical background that a sense of control and self-efficacy can promote psychological well-being. The main questions of this study included the following: What were the main problems experienced by older Iranian women during the outbreak of COVID-19? What coping methods did they use to control the situation? What were their views on the future? This research was conducted in Kerman city, the capital of Kerman Province. A phenomenological method was used. We interviewed 15 women over 65 years old. We extracted five main themes from the interviews. These themes were health issues, persistent anxiety, economic and social pressures, identifying unique solutions to the current situation, and optimism versus pessimism: what is the future? From the participants' point of view, psychological, social and physical problems have disturbed them during the pandemic, especially at the beginning. However, they controlled their problems by using selective coping strategies. In Iran, planners can use the potential of the two institutions of family and religion to reduce the problems of older adults.

State containment measures, living arrangements, and mental health of U.S. older adults during the COVID-19 pandemic

OBJECTIVES

Early in the coronavirus pandemic, U.S. states implemented several different types of containment measures to slow the disease's spread. Early evidence indicates containment measures were associated with changes in individuals' mental health. This study explores the associations between U.S. state containment measures and older adults' mental health and importantly, whether the associations vary by living arrangement and gender.

METHODS

The study analyzed national sample of adults aged 50 or older from 12 waves (April-July 2020) of the U.S. Household Pulse Survey (N = 394,934). State fixed-effects models linked four state containment measures (stay-at-home order, restaurant closure, bar closure, and movie theater closure) to levels of depression and anxiety across different types of living arrangements, net of controls. Men and women were analyzed separately.

RESULTS

Stay-at-home order and restaurant and bar closure, but not movie theater closure, were associated with higher levels of depression and anxiety in older adults. Living arrangements moderated the associations for women but not men. For women, compared to living alone, living with a spouse or intergenerational family was associated with higher levels of anxiety and depression during stay-at-home order and restaurant closure.

CONCLUSION

The associations between containment measures and mental health vary by type of living arrangement and were gendered, likely because household situations create different demands and supports that men and woman experience differently. Although containment measures are necessary to protect public health, paying attention to these underlying dynamics can inform policymakers' efforts to implement policies that balance harms and benefits for older adults.

Level of Concern, Spending, and External Support Related to COVID-19: A Comparison between Working and Non-Working Older Adults

This study compared levels of concern, spending, and use of external support by working status among older adults in the U.S. during the COVID-19 pandemic. It assessed whether work influences these variables related to wellness. Data from 2489 older adults from the 2020 U.S. Health and Retirement Study were analyzed using multiple linear and logistic regression. Older adults who worked had lower concerns about the pandemic (β = -0.28, p = 0.048), were less likely to increase their spending (OR = 0.74, p = 0.041), and were less likely to use external support (OR = 0.50, p < 0.001). Use of external support increased with age (OR = 1.04, p < 0.001) and increased spending (OR = 1.32, p = 0.019). Married older adults were less likely to increase spending (OR = 0.75, p = 0.007) and had lower concerns toward COVID-19 (β = -0.28, p = 0.011). Higher levels of concern were reported among women (β = 0.31, p = 0.005) and participants who had friends or family members diagnosed with COVID-19 (β = 0.51, p < 0.001). Women were more likely to use support (OR = 1.80, p < 0.001). Work appears to bolster older adult wellness outcomes.

The Impact of COVID-19 Restrictions on Perceived Health and Well-Being of Active Australian Older Adults

The aim of this study was to determine the impact of COVID-19 restrictions on older adults' perceived health and well-being according to different types of participation in sport and physical activity by gender and region. A survey was implemented during the first COVID-19 lockdown in Australia (June 2020) and information collected on demographics, sport and physical activity patterns pre-COVID-19, and health and well-being outcomes during lockdown and compared to 1 year earlier. During COVID-19 lockdown, older adults who participated in both club sport and informal activities had significantly better general health, physical health, and resilience than those who participated solely in a single setting. Those participating in both team and individual activities reported better general well-being. Older adults who were active in a range of settings and modes had improved health and well-being. Social support is especially important for older adults to become and remain active.

Mourning in a Pandemic: The Differential Impact of COVID-19 Widowhood on Mental Health

OBJECTIVES

The death of a spouse is an established predictor of mental health decline that foreshadows worsening physical health and elevated mortality. The millions widowed by COVID-19 worldwide may experience even worse health outcomes than comparable pre-pandemic widows given the particularities of dying, mourning, and grieving during a pandemic defined by protracted social isolation, economic precarity, and general uncertainty. If COVID-19 pandemic bereavement is more strongly associated with mental health challenges than pre-pandemic bereavement, the large new cohort of COVID-19 widow(er)s may be at substantial risk of downstream health problems long after the pandemic abates.

METHODS

We pooled population-based Survey of Health, Ageing and Retirement in Europe data from 27 countries for two distinct periods: (1) pre-pandemic (Wave 8, fielded October 2019-March 2020; N = 46,266) and (2) early pandemic (COVID Supplement, fielded June-August 2020; N = 55,796). The analysis used a difference-in-difference design to assess whether a spouse dying from COVID-19 presents unique mental health risks (self-reported depression, loneliness, and trouble sleeping), compared with pre-pandemic recent spousal deaths.

RESULTS

We find strong associations between recent spousal death and poor mental health before and during the pandemic. However, our difference-in-difference estimates indicate those whose spouses died of COVID-19 have higher risks of self-reported depression and loneliness, but not trouble sleeping, than expected based on pre-pandemic associations.

DISCUSSION

These results highlight that the millions of COVID-19 widow(er)s face extreme mental health risks, eclipsing those experienced by surviving spouses pre-pandemic, furthering concerns about the pandemic's lasting impacts on health.

U.S. Election 2020: Intentions to Participate in Political Crowdfunding during COVID-19 Pandemic

Participation in the political process is the fundamental right and responsibility of a citizen. Online political participation has gained popularity as it is convenient and effective. Political crowdfunding helps political candidates and parties pledge funds, usually small, from a large population and seek support through marketing campaigns during elections. In November 2020, when there were presidential elections in the US and the world was facing a global pandemic from COVID-19, political crowdfunding was a helpful method to communicate the political agenda and seek funding. The study aims to examine the intentions of US citizens to participate in political crowdfunding amid the COVID-19 pandemic. The study will integrate two models—the theory of planned behavior and civic voluntarism model—to check intentions and, in addition, the influence of COVID-19. The data were collected from 529 respondents from the US before the elections. The data were analyzed through a partial least squared structural equation modeling technique with SmartPLS 3.2. The results suggested that political efficacy and online community engagement have a positive influence on the intention to participate in political crowdfunding. Further, all three factors of TPB have a significant positive influence on intention. The perceived threat variable of COVID-19 does impact the attitude towards political crowdfunding. The study will be helpful for crowdfunding platforms and political contenders to examine the factors that can help them to seek maximum funds from the public and, at the same time, examine the effectiveness of their political communications.

Examining Risk Factors for Mental Health During the COVID-19 Pandemic—Focusing on Older Adults in South Korea

Objectives: Mental health is the cornerstone of public health, particularly for older adults. There is a clear need to examine the impact of COVID-19 on mental health among older adults in South Korea, where the incidence of COVID-19 was relatively low and widespread transmission was controlled without a national lockdown.

Methods: This analysis included a total of 1917 participants from the Experience Survey on Healthcare Use of Older Adults, which was conducted for adults aged 65 years or older by face-to-face interview.

Results: The results showed that older adults with a good understanding of COVID-19 public health measures were less likely to experience mental health problems. In contrast, those with a greater risk perception of contracting COVID-19 had higher odds of experiencing tension and anxiety in addition to sadness and depression. Older adults who had a greater fear of COVID-19 and perceived higher-risk of contracting COVID-19 experienced more sleep problems.

Conclusion: The findings provide new evidence on the factors that influence the mental health of older adults in South Korea during the pandemic and suggest the development of policy interventions.

Mapping Sustainability across the World: Signs, Challenges and Opportunities for Democratic Countries

This article aims to create the nexus between sustainable development and the quality of the political regime. The study aims to respond to the following research questions: “how could influence the quality of the democracy the dynamics of the Sustainable Development Goals (SDGs 17)?” and “what are the premises for sustainable development in the new political context, characterized by democratic recession?” The purpose of the study is to underline the fact that democratic regimes are inclined to create both participative and deliberative frames for achieving the SDGs in accordance with UN 2030 Agenda. The research methodology used in this study is based on descriptive and inferential statistics. The research data are collected from secondary sources in the years between 2015 and 2021, from 193 countries covering all the geographical areas. The empirical results suggest two models of development: the Asian model of sustainable development characterized by economic growth and the Western democratic model based on democratic institutions, fair justice and mechanisms for preserving peace. We noticed that the key-variables for explaining the dynamics of sustainability in correlation with democratic index are represented by the functioning of the governments and the political participation. Through civic engagement and political accountability, democracy could be seen as a pre-requisite for achieving an optimal level of the SDGs. All these empirical results could prove valuable for the scholars interested in the relation between democracy and sustainability and for the political decision makers involved in shaping strategies for social, economic and environmental development.

Perceptions of older adults? Measuring positive, negative, and physical descriptors using the stereotype content and strength survey

The COVID-19 pandemic has disproportionately impacted the health of older adults. In addition to a higher risk for serious illness and death, the societal value of senescent adults was challenged. There have been conflicting results reported in the research literature regarding positive and negative stereotypes of older adults, and areliable and valid assessment tool to measure content (existence of astereotype) and strength (intensity of astereotype) is unavailable. To address issues with instruments employed to measure ageist stereotypes, researchers developed the Stereotypes Content and Strength Survey. University students (n=483) were directed to "think about their perceptions of older adults" and indicate how many they believed could be described using the terms listed on a5-point Likert-type scale from none-all. Response categories for each descriptive item were dichotomized into 1 = "some, most or all" and 0 = "none or few." Based on an odds analyses of 117 items, 84 met the content criteria to be considered astereotype regarding older adults. Using the criteria for strength, items were categorized into 36 "strong," 25 "moderate," and 23 "weak" stereotypes. Assessing the content and strength of stereotypic beliefs using this procedure may contribute to major bias influencing ageist perceptions.

The effect of COVID-19 pandemic-related financial challenges on mental health and well-being among U.S. older adults

Background

Despite profound financial challenges during the COVID‐19 pandemic, there is a gap in estimating their effects on mental health and well‐being among older adults.

Methods

The National Health and Aging Trends Study is an ongoing nationally representative cohort study of US older adults. Outcomes included mental health related to COVID‐19 (scores averaged across eight items ranging from one to four), sleep quality during COVID‐19, loneliness during COVID‐19, having time to yourself during COVID‐19, and hopefulness during COVID‐19. Exposures included income decline during COVID‐19 and financial difficulty due to COVID‐19. Propensity score weighting produced covariate balance for demographic, socioeconomic, household, health, and well‐being characteristics that preceded the pandemic to estimate the average treatment effect. Sampling weights accounted for study design and non‐response.

Results

In weighted and adjusted analyses (n = 3257), both income decline during COVID‐19 and financial difficulty due to COVID‐19 were associated with poorer mental health related to COVID‐19 (b = −0.159, p < 0.001 and b = −0.381, p < 0.001, respectively), poorer quality sleep (OR = 0.63, 95% CI: 0.46, 0.86 and OR = 0.42, 95% CI: 0.30, 0.58, respectively), more loneliness (OR = 1.53, 95% CI: 1.16, 2.02 and OR = 2.72, 95% CI: 1.96, 3.77, respectively), and less time to yourself (OR = 0.54, 95% CI: 0.40, 0.72 and OR = 0.37, 95% CI: 0.27, 0.51, respectively) during COVID‐19.

Conclusions

Pandemic‐related financial challenges are associated with worse mental health and well‐being regardless of pre‐pandemic characteristics, suggesting that they are distinct social determinants of health for older adults. Timely intervention is needed to support older adults experiencing pandemic‐related financial challenges.

COVID-19: Financial well-being of older Australians in times of crisis

OBJECTIVE

The aim of the present study was to explore the impact of the COVID-19 pandemic on the financial well-being of older Australian retirees.

METHODS

Thirty Australian retirees (16 females and 14 males), older than 65 years of age, were asked 'Have your finances been affected by the events surrounding COVID-19?'. Data were analysed using Braun and Clarke's six-step approach, and Bronfenbrenner's socio-ecological model was utilised to analyse thematic responses at individual, household, community and societal levels.

RESULTS

Two COVID-19-related themes emerged from interviews: COVID-19 and increased financial stress and COVID-19 and frustration with digital banking.

CONCLUSIONS

This study revealed that the financial well-being of older Australians and especially self-funded retirees has been negatively impacted by the COVID-19 pandemic. Participants felt financially worse off primarily due to the volatility of the financial markets, the need to support adult children and the increased cost of living. Also, participants expressed their hesitation and frustration with digital banking services, and their desire for greater personal contact with financial institutions, particularly during times of uncertainty.

How Has the Nationwide Public Health Emergency of the COVID-19 Pandemic Affected Older Chinese Adults' Health Literacy, Health Behaviors and Practices, and Social Connectedness? Qualitative Evidence From Urban China

Older Chinese adults' daily lives have been affected significantly during the outbreak phase of the COVID-19 pandemic since January 2020. They were confronted with activity restrictions due to strict pandemic prevention. The older population also had to get accustomed to widely-used modern technologies in community management, such as health codes and WeChat groups. By late 2021, mainland China had reduced the prevalence of COVID-19, and people's daily lives had primarily returned to pre-pandemic normality. Under China's systematic health management during the pandemic, older Chinese adults' responses to this nationwide public health emergency may have influenced their health in the long run. However, it remains unclear what specific health changes or improvements have occurred. Such a void in the literature is worrying, given that older adults are at high health risks due to the pandemic which, might still be with humankind for a while. Thus, it is of necessity to explore and report their health changes after this official, large-scale health intervention. In this study, 17 adults aged 55 and above were recruited as interviewees. All interviewees reside in a community located in Q district, N city of the People's Republic of China. According to the findings, many interviewees now have better literacy in health risk prevention. Information and Communication Technologies (ICTs) play a significant role in getting access to health information. Specifically, television, WeChat chatting groups, and TikTok could be valuable information sources for older adults. As for the understanding and evaluation of health information, although older participants can distinguish COVID-19 rumors, they may sometimes feel confused about the underlying scientific logic. Regarding changes in health behaviors and practices, many older adults can integrate health information and knowledge into their daily lives. Additionally, although interviewees can keep important social connections, not all of them are familiar with using new ICTs, such as online chatting group, for social participation and engagement. The empirical evidence suggests that both the communities and the local governments can offer specific training programs to older residents for the sake of enhancing their health literacy, health behaviors and practices, and social connectedness during and after the pandemic.

Diverse experiences among older adults in Aotearoa/New Zealand during COVID-19 lockdown: A qualitative study

OBJECTIVES

There are mixed results from studies of COVID-19-related anxiety. We explored older people's perspectives on anxiety and support during lockdown.

METHODS

We thematically analysed 730 written comments from older community-dwelling adults aged 55-85 years in Aotearoa/New Zealand.

RESULTS

Despite some anxiety during lockdown, for those who were retired, working at home or receiving wage subsidies, the experience was very enjoyable. Whether living alone or in households, anxieties were largely ameliorated by a sense of support from family, fellow citizens and government. In contrast, essential workers, those who lost employment and informal carers did not feel sufficient community support to alleviate their anxiety.

CONCLUSIONS

Concerns about the plight of older people focus on stereotypes of isolated elders, ignoring the needs of workers and carers. The inductive approach taken to this study provided useful information about the success of supportive measures and highlighted the need to broaden the focus of concern.

Older Europeans' experience of unmet health care during the COVID-19 pandemic (first wave)

BACKGROUND

During the COVID-19 pandemic the utilization of health services has changed. People were living in a very different social, economic and epidemiological context. Unmet health care is expected to happen. The purposes of this work are i) to compare the differences between unmet care across countries, ii) to find the main factors which are associated with unmet health care, which includes giving up and postponing medical care, as well as denial of medical care provision by the health services, and iii) to determine if health systems' characteristics and government decisions on lockdown were related to unmet care.

METHODS

We have used the most recent dataset collected by the SHARE-COVID Survey during the summer of 2020. These data cover all EU countries and are applied to people over 50. We have estimated a set of logistic regressions to explain unmet health care.

RESULTS

The results indicate that women, people who are slightly younger, with higher education and income, who find it hard to make ends meet each month, and people with poorer health were more likely to experience unmet health care. We also found that in health systems with high out-of-pocket payments people are more likely to give up health care while in countries with previous high levels of unmet health needs this likelihood was the opposite; people in countries with a high number of beds per capita and with a Beveridge-type health system were reporting less postponement of health care.

CONCLUSION

Some policy measures may be suggested such as social and economic measures to mitigate loss of income, expansion of the points and forms of access to health care to improve utilisation.

The Relationship Between Financial Worries and Psychological Distress Among U.S. Adults

This study examines the association between financial worries and psychological distress among US adults and tests its moderating effects by gender, marital status, employment status, education, and income levels. Data were derived from the cross-sectional 2018 National Health Interview Survey (NHIS) of the adult population. The hierarchical regression analysis revealed that higher financial worries were significantly associated with higher psychological distress. Additionally, the association between financial worries and psychological distress was more pronounced among the unmarried, the unemployed, lower-income households, and renters than their counterparts. The findings suggest that accessible financial counseling programs and public health intervention programs are needed to mitigate financial worries and its negative influences on overall psychological health, with greater attention devoted to vulnerable populations.

Sustainability and Employability in the Time of COVID-19. Youth, Education and Entrepreneurship in EU Countries

This paper aims to identify several changes in the labor market structure in COVID-19 pandemic times. The context of the research is represented by the influence of the COVID-19 pandemic in the economic field, especially at the labor market level. This difficult situation could generate a negative impact in the sphere of traditional jobs and economic sectors. The main challenge for sustainable development in this new global situation is represented by human sustainability. Related to human sustainability, we emphasized the role played by the labor market and employability in mantling an optimal function at the social and economic level. For measuring the impact of the COVID-19 pandemic in the economic sphere, we used a quantitative design based on descriptive and inferential statistics. The research variables are represented by unemployment rates in the EU-28, employability rates, educational levels, gender, economic growth, labor mobility, material deprivation, economic freedom, and human development indicators. Empirical findings present the situation of a deep economic crisis generated by economic degrowth and by high levels of unemployment rates in the EU-28. Moreover, we have observed several predictors of employability in the new pandemic context as: material deprivation by age (in the field of young people), employment rate by education (tertiary education), and economic freedom. Another important finding is related to the gender perspective. Statistical correlations estimate a positive linear correlation between gender (women) and low rates of employability in the EU-28. All these empirical results could prove valuable for scholars interested in the relations between employability and sustainability and for political decision makers involved in the effort of reducing the negative effects of the COVID-19 pandemic within national and trans-national economic systems.

Mental health trajectories of individuals and families following the COVID-19 pandemic: Study protocol of a longitudinal investigation and prevention program

Introduction

Many adults, adolescents and children are suffering from persistent stress symptoms in the face of the COVID-19 pandemic. This study aims to characterize long-term trajectories of mental health and to reduce the transition to manifest mental disorders by means of a stepped care program for indicated prevention.

Methods and analysis

Using a prospective-longitudinal design, we will assess the mental strain of the pandemic using the Patient Health Questionnaire, Strength and Difficulties Questionnaire and Spence Child Anxiety Scale. Hair samples will be collected to assess cortisol as a biological stress marker of the previous months. Additionally, we will implement a stepped-care program with online- and face-to-face-interventions for adults, adolescents, and children. After that we will assess long-term trajectories of mental health at 6, 12, and 24 months follow-up. The primary outcome will be psychological distress (depression, anxiety and somatoform symptoms). Data will be analyzed with general linear model and machine learning. This study will contribute to the understanding of the impact of the COVID-19 pandemic on mental health. The evaluation of the stepped-care program and longitudinal investigation will inform clinicians and mental health stakeholders on populations at risk, disease trajectories and the sufficiency of indicated prevention to ameliorate the mental strain of the pandemic.

Ethics and dissemination

The study is performed according to the Declaration of Helsinki and was approved by the Ethics Committee of the Department of Psychology at the Humboldt Universität zu Berlin (no. 2020-35).

Trial registration number

DRKS00023220.